My time as Lessons Learnt (LL) Lead has illustrated both how leadership can serve to improve patient safety and the role of reflection in ongoing development as a junior leader.

‘Lessons Learnt: Building a Safer Foundation comprises an NHS patient safety training programme, wherein Foundation trainees lead a peer-group discussion and analysis of a patient safety incident (PSI) in a safe, facilitated forum’. I facilitated discussion around incidents raised by participants, ranging from analgesia delay for fracture patients, to missed diagnosis of a rare and sadly fatal chemotherapy side-effect. Our objectives were focussed around acquiring patient safety knowledge, skills and attitudes.

The project appeared to garner positive feedback. However, something changed two or three sessions in: motivation dropped. Despite excellent speakers, there was a fatigue in engagement. Holding group and individual discussions, I identified that LL sessions left participants feeling like there wasn’t enough action – what are we actually doing to help patients?

One objective in the LL course guide states: ‘raise and act on concerns about patient safety’. I decided to make this a priority by including a larger element of quality improvement. In the final LL session of the year we looked back over PSIs and identified what could be actioned in the form of a QI project. With participants in smaller groups, I tasked each group to create a SMART aim, a measure for said aim and a timescale. Projects are ongoing around the themes of safe prescription, inter-staff communication and awareness of safety protocols. Feedback has been overwhelmingly positive.

My leadership lessons throughout the process:

• set wider team goals overarching regular session objectives

• team demotivation is something to be explored, not feared

• engaging and useful feedback, though time–consuming, can make all the difference

• use methodology that participants know well to bridge gaps in progress.